GP Lens Care Options
By Gregory W. DeNaeyer, OD, FAAO
The success of a GP lens patient depends on a lens that provides good vision and comfortable wear, and these provisions are directly dependent on lens care. For some practitioners, this step in the fitting process may be an afterthought. However, tailoring a lens care regimen based upon an individual patient's needs and physiology can make the difference between success and failure. If the patient is new to GP wear, then some patient-specific lens care adjustments may take place later—after weeks or months of lens wear.
Keeping a GP lens free of deposits (Figure 1) is paramount to vision and lens comfort. Also, keep in mind that deposits may harbor microorganisms or initiate contact lens papillary conjunctivitis (CLPC). Abrasive cleaners, such as Boston Cleaner (Bausch + Lomb), Boston Advance Cleaner (Bausch + Lomb) and Opti-Free Daily Cleaner (Alcon), allow the patient to scrub away protein or lipids that can build up on the surface of a GP lens. Caution should be used when using these cleaners on high Dk materials because their abrasive nature can cause changes in the lenses refractive and fitting characteristics. A less abrasive solvent based cleaner is Optimum extra strength cleaner (Lobob).
Storage and Disinfection
Patients who use daily cleaners will need to store their lenses in a solution that disinfects and conditions the lens for next day use. A few of the available products include Boston Advance Comfort Formula Conditioning Solution (Bausch + Lomb) and Boston Conditioning Solution (Bausch + Lomb). Back-up lenses should be stored dry and then cleaned and conditioned prior to wear.
Figure 1. Surface GP deposits.
Patients who are heavy depositors may periodically need an extra cleaning step to their regimen. Liquid enzymatic or protein removers can be a relatively easy and effective way to keep lenses clean. Examples include Opti-Free Supra-Clens Daily Protein Remover (Alcon) or Boston One-Step Liquid Enzymatic Cleaner (Bausch + Lomb). Severe deposition can often be effectively removed using Menicon's Progent cleaner (only approved in the United States for professional in-office use).
Patients with sensitivities to active or inactive ingredients may have improvement switching to a peroxide based care system, such as Clear Care (Ciba Vision). Keep in mind GP lenses have to first be digitally massaged with Clear Care before soaking.
The are a few products available for patients who are not heavy depositors and prefer a multi-purpose product. Opti-Free GP (Alcon), Simplus Multi-Action Solution (Bausch + Lomb) and Optimum C/D/S (Lobob) are combination solutions that work well for select GP patients.
Time + Effort = Success
Taking the time and effort to prescribe a care system for each individual GP patient is critical for maximizing long-term vision, comfort and success. CLS
Dr. DeNaeyer is the clinical director for Arena Eye Surgeons in Columbus, Ohio. His primary interests include specialty contact lenses. He is a consultant/advisor to Visionary Optics and an advisory panel member of Inspire Pharmaceuticals. Contact him at firstname.lastname@example.org.